ARA-II en la insuficiencia cardiaca con función sistólica normal. ¿Dónde estamos y adónde vamos?

Heart failure with normal systolic function is characterized by abnormal ventricular filling during diastole due to poor elasticity or distensibility. More than a third of all cases of heart failure result from diastolic dysfunction. In a significant number of cases, the underlying anatomical defect is left ventricular hypertrophy, which is closely related to chronic arterial hypertension. Drugs that block the renin-angiotensinaldosterone system not only control blood pressure, but have also been shown to improve functional capacity in these patients. Moreover, there is evidence that this group of compounds is effective in reducing both left ventricular mass and myocardial fibrosis. The results of the CHARM-Preserved trial showed that treatment with candesartan can reduce the hospitalization rate in these patients. These findings should be taken into account in planning treatment for patients with this pathophysiological form of heart failure.